This week in clinical, I took care of a patient who recently had a hemiglossectomy. Due to the nature of the surgery, she had many tubes and wounds to assess and take care of. My goal coming into this week of clinical was to learn how to give meds through a standard feeding tube, empty a JP drain, and work a Doppler. I didn’t want my clinical experience to be consumed with learning the technical application, however, so an additional goal was to focus on what my patient was expressing as a need. On the first day of clinical, I mainly focused on the technical skills. Working with a client that needed so much care proved to be hectic at first. I didn’t know how to take care of her, because I have never worked with a feeding tube, JP drain, or Doppler before. There was so much that needed to be done before I even gave the patient her tube feeding. Her blood glucose needed to be checked, and then residuals. It was important to check pain before, also, so that pain medication could be given without having to stop the tube feeding. It seemed like right after I was done with …show more content…
I came into the day with a better plan of care. I organized my orders so that they were all clustered together and I didn’t have to constantly be moving from one task to the next. I was also confident that I knew how to take care of my patient. This is the day that I wanted to focus more on my client’s concerns and teaching. I think that I did well with my client teaching. I was able to help with her concern of coverage for care after discharge and taught her about her feeding tube. I think that I could have done more with teaching, however. I wish I had allowed her to be more hands on with the feeding tube, so she could get more practice with it before leaving the hospital. I know that she will get practice with the dietician, but the more practice she gets, the more comfortable she will be after the
When I was working at long term care, I was being a part of an incident which gave me a life time lesson. I was taking care of ninety-nine years old lady Mrs.Chang. I was assisting Mrs. Chang in transferring from bed to wheelchair. I feel Mrs. Chang physically so weak so I need someone’s sustenance. I was looking for someone and I saw a nurse in next resident’s room who was dressing a wound of resident Mr. Roger. I call the nurse to give me a hand. She rushes into Mrs.Chang room without washing her hand or using hand sanitizer to assist me in transfer. I was jolted for a moment and couldn’t say anything to the nurse. Then I felt it was too late to say anything to the nurse.
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
provide the care that her patient so desperately needed and deserved at that moment and
In this essay, I will discuss three clinical skills that I undertook during the six weeks placement: Giving an insulin injection, hand washing and dressing a trauma wound.
Looking back on my goals for this clinical day, I would state that I did meet my goals. My overall goal was to become familiar with the clinical setting and the tasks that I would be asked to complete, and I feel that I completely met this goal. As the day progressed, I found myself receiving more exposure to the clinical setting and how to effectively perform skills. Following the concept of safety, I do feel that I met a majority of my goals for safety. During the day, I was able to explore my assigned patient, both by viewing her medical record and by interacting with her directly. This process sanctioned me to acquire the necessary information for my three primary diagnoses, medications, and the start of my concept map. While working with my assigned patient, and other patients on the floor, I remained aware of my surroundings and implemented safety precautions when needed. In the process of patient care and safety precautions, I relied on my therapeutic communication skills to drive my interactions with the CNAs, the nurses, and the patients on the floor. Of my goals set, the only one that I did not completely accomplish was working on all of my beginner skills. Two of the skills I did not get to practice were feeding and bathing/showering. Because I did not receive exposure to these skills today, I plan on making sure I practice these two skills on the next clinical day. Overall, I am pleased with the first clinical day and everything I was permitted to accomplish.
Utilising John’s model of structured reflection I will reflect on the care I instigated to a patient with complex needs. The patient in question was admitted to the Emergency Assessment Unit for surgical patients then transferred to the ward where I work as a staff nurse.
My first patient that I started as student nurse on one of the long Rehab Center was a seventy two year old man who had Clostridium difficile (C.diff), Dementia, Hip replacement, and Obesity. Due to the above sickness he had many complications. I can still remember his face suffering from pain. Because of his lack of ambulation and incontinence, he had developed a very serious pressure ulcer under his sacral area. I went through to the room with my instructor and the instructor introduces me for the patient as his student nurse from Towson University and will taking care of him. However the patient was not happy and he becomes a challenging patient in my first experience day. But I may learned more from that challenging patient for my future experience.
This experience will definitely influence my future practice; my action plan would be using those teaching strategies in preparing students to face the clinical environment, to ensure optimal patients’ health outcomes and it helps to build a competent and independent clinician.
Therapy Analysis The purpose of this paper is to examine the efficacy of my work as a co-therapist during the fifth session with the simulated couple Katy and Michelle. I will discuss our therapy agenda and the goals we hope to attain during the session. It is prudent to begin by giving a brief outline of the couple’s present problem and the patterns of dysfunction that I have identified within their relationship. In my opinion, it is the therapist’s job to recognize patterns and behaviors that disrupt the intimate bond between the partners.
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
For example, patients who are going in for major abdominal surgery, or even normal childbirth. Nurses should enable them and see them through the fearful mindset that something major is about to happen, or is happening. We are looked upon and expected to “enable” them. To continually move the patient forward, the nurse may do this by offering positive feedback, coaching and enhancing their optimistic belief or helping the patient to see the positivity in their situations, and/or determine healthy alternatives.
I believe placing student nurses in the clinical setting is vital in becoming competent nurses. Every experience the student experiences during their placement has an educative nature therefore, it is important for the students to take some time to reflect on these experiences. A specific situation that stood out to me from my clinical experience was that; I didn’t realize I had ignored the patient’s pain until I was later asked by the nurse if the patient was in any pain.
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).